Article Figures & Tables
Tables
- Box 1: Roles and responsibilities for toxigenic diphtheria follow-up
Sector Roles and responsibilities Health care (e.g., hospitals, community clinics) Provide prompt diagnosis and treatment
Report promptly to local public health
Institute appropriate infection prevention and control measures
Support assessing close contacts (via collection of nasopharyngeal and throat swabs)
Support follow-up of any health care workers identified as close contacts who require contact management
Public health (e.g., local, provincial, national) Local public health:
Begin contact management immediately
Conduct local surveillance
Support collection of swabs and immunization of contacts
Lead community contact management
Lead community messaging, if required
Provincial public health (e.g., Ministry of Health, Public Health Ontario):
Coordinate access to diphtheria antitoxin
Provide advice or consultation to local public health
Conduct provincial disease surveillance
Coordinate notification to Public Health Agency of Canada, as needed
National public health (e.g., Public Health Agency of Canada):
Conduct national surveillance activities
Liaise with other national governments for contact tracing in home country, as needed
Laboratory (e.g., front-line, provincial reference laboratory, National Microbiology Laboratory) Front-line laboratories:
Process primary specimens and provide preliminary identification
Provincial reference microbiology laboratories:
Confirm identification, and if determined to be Corynebacterium diphtheriae, submit isolate to National Microbiology Laboratory
Process primary samples to culture specifically for C. diphtheriae when suspected (e.g., contacts of a case)
National Microbiology Laboratory:
Perform tox-gene polymerase chain reaction testing (PCR) to determine if isolate possesses the toxin gene; if tox PCR is positive, perform a modified Elek test to definitively show that the isolate produces diphtheria toxin
All levels: Provide advice regarding testing, turnaround times, interpretation